Anthem Silver Blue Value HMO 4000 $10 $0 Virtual PCP $0 Select Drugs

Anthem Blue Cross and Blue Shield · 2026 plan year

Silver
Ind. deductible
$4,000
Family deductible
$8,000
Ind. OOP max
$10,150
Family OOP max
$20,300

Compare with other Silver plans in GA

Side by side: deductibles, out-of-pocket limits and copays.

More Anthem Blue Cross and Blue Shield plans in GA

Monthly premiums by age

Rating Area 6 — the lowest-priced of the 10 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$344$344
21$449$449
30$510$561
40$574$631
50$802$882
60$1,219$1,341
64 and over$1,347$1,482

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$10.00

Specialist

BenefitIn-network
Specialist Visit$65.00

Hospital

BenefitIn-network
Emergency Room Services$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$400.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services40.00% Coinsurance after deductible
Urgent Care Centers or Facilities$50.00

Pharmacy

BenefitIn-network
Generic Drugs$3.00
Non-Preferred Brand Drugs40.00% Coinsurance after deductible
OFF_LABEL_DRUGS45.00% Coinsurance after deductible
Preferred Brand Drugs$60.00
Specialty Drugs45.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$400.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services40.00% Coinsurance after deductible

Other

BenefitIn-network
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40.00% Coinsurance after deductible
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental$65.00
AcupunctureNot covered
Allergy Testing40.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Bone Marrow Transplant$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Chemotherapy40.00% Coinsurance after deductible
Chiropractic Care40.00% Coinsurance after deductible
CLINICAL_TRIALS$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Cosmetic Surgery$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Care$65.00
Diabetes Education$65.00
Dialysis40.00% Coinsurance after deductible
Durable Medical Equipment40.00% Coinsurance after deductible
Emergency Transportation/Ambulance40.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services40.00% Coinsurance after deductible
Hearing Aids40.00% Coinsurance after deductible
HEART_TRANSPLANT$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Home Health Care Services40.00% Coinsurance after deductible
Hospice Services40.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$300.00 Copay after deductible + 50.00% Coinsurance after deductible
Infertility Treatment40.00% Coinsurance after deductible
Infusion Therapy40.00% Coinsurance after deductible
Inpatient Physician and Surgical Services40.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services40.00% Coinsurance after deductible
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling40.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$10.00
Outpatient Rehabilitation Services40.00% Coinsurance after deductible
Prenatal and Postnatal Care40.00% Coinsurance after deductible
Private-Duty NursingNot covered
Prosthetic Devices40.00% Coinsurance after deductible
Radiation40.00% Coinsurance after deductible
Reconstructive Surgery$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy40.00% Coinsurance after deductible
Rehabilitative Speech Therapy40.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility40.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$400.00 Copay per Stay after deductible + 50.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services40.00% Coinsurance after deductible
Transplant$400.00 Copay after deductible + 50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40.00% Coinsurance after deductible
Weight Loss Programs$65.00
Well Baby Visits and CareNo charge
Well Child CareNo charge
X-rays and Diagnostic Imaging40.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 187 geographic areas. 88 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.

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